The time I (almost) got fired.

[BambiBelle07]

I started my first job at a private practice a little less than a year ago. I was 6 months out of school when I got this job and I've been pretty happy there. The MD I work for always commends me on my clinical skills and kindness towards our patients. Even though I was (and still am) new to the field, I felt confident that I was doing a great job and that the MD was happy with my work, that is until last week.

I was called to his office, which had never happened before so I had a feeling something was up. He had a couple copies of immunization records that were input by me into our EHR the week before. Now I have no idea how this happened because I'm always careful when I input/document anything because I know it's one of the most important, if not the most important part of healthcare. Throughout school I was always told to document document document. I couldn't believe my ears when the MD informed me I entered several dates incorrectly (I wrote 21 when it should have been 12) and forgot to document a few immunizations. Then he started grilling me on how important it is to be 100% accurate, which I know. I know how important this is for patient safety. I thought for sure I was going to get fired, but I'm getting a second chance because the MD likes me on his team. I told the MD how sorry I was and that I understood the severity of my mistake. I promised I would be extra careful from now on and triple check my work. I cannot let this happen again. I learned my lesson.

Basically my confidence is so low right now. I had to input more immunizations in the next day and although I triple checked my work like I said I would and took longer than I normally would, I'm still worried I missed something and will get fired. How does someone come back from something like this? Does anyone have any similar experiences so I know I'm not alone? I feel so stupid for missing something so huge.

And as I know this is a forum for nurses, I'm an MA in case anyone was wondering. I know what I did was a big mistake and how serious it could have been if it wasn't caught, so please no rude comments.

[CVICU-Nurse1.5]

Did you learn from it? If yes then move on and stop worrying. If no, you will repeat it until you learn.

I'd tell the doctor thanks for making me a better employee.

[Libby1987]

For things like that, try to tune out any distractions which can pull your focus and cause errors. And that includes thought distractions, try not to mentally multi task.

[BambiBelle07]

I absolutely learned from this knowing my job is on the line, hence why I was extra careful the next time I put in immunization a. I don't think anyone would want to hire someone who made a date error, so I really can't get fired.

[jadelpn, LPN, EMT-B]

Do you also give immunizations? If so, you should take the paperwork and the vial together to document, make sure you double check the date (and immunization dates are important, as sometimes they are what are needed by a certain date to be able to attend school, take a trip, that type of thing). Make sure the date adds up with the date on the visit note. And always be sure you are giving the correct immunization to the correct patient. (or if you don't give immunizations, be sure that whomever does gives you what you need to scribe correctly.) And sometimes, if you are scribing intently, you can type in the wrong month, they may say the wrong month... especially when it is busy.

The bottom line is, your error is the MD's error--or the primary RN or LPN's error, as they are the people holding the licenses. So they do sometimes come down hard on unlicensed assistive personal, as they have to take "blame" for mistakes you may make. With that being said, in a busy office with lots of things going on, people make mistakes. Document as you go, do not leave it for the end of the day, and always double and triple check. Yes, it may slow you down, but that's ok--it is most important to be correct. Especially with time sensitive/time dependent immunization schedules.

[BambiBelle07]

The Immunizations with incorrect dates were not administered by me. They were administered by another provider/RN/MA. These were new patients and I was inputting their records into their chart. So this might have very well been me having a difficult time reading the writing of the person who wrote the immunization dates on the record. I give Immunizations and I always make sure I have the right vaccine, since I'm new and learning, I look up the dose, and make sure I'm giving it to the right patient. I always bring in a piece of paper with me so I can write the time, location and date. Then once I give the shot, I transfer what I wrote to the EHR.

You are right. I'm sure the MD was worried about his license. I am fully aware that a patients safety would have been at risk if we gave an immunization when the series has already been complete. I still cannot believe I allowed myself to let this happen. It's just myself and the MD in the office, so I don't have a coworker I could ask when it comes to the issue of another person's handwriting and the MD doesn't have time for that.

[jadelpn, LPN, EMT-B]

It stinks being new, and having to input other people's stuff--and not great practice, but admittedly, I have little experience in an MD office setting.

In a perfect world, every provider/nurse/MA who gives a medication/immunization would have to document it themselves, so it decreases the margin of error. But because you are new at the office, not sure if that thought process was lightly suggested as something to try going forward would be taken into consideration or not.

[BambiBelle07]

Being new stinks big time, especially because I was a top student and people came to me for assistance. So it sucks being at the bottom again. The Immunizations I was inputting were patients transferring from another facility (like they went to one doctor and are now switching to the one I work for). Sorry if I wasn't clear. I wish the Immunization cards we received were typed. I think that would decrease the margin of error too.

[OCNRN63, RN]

Do you also give immunizations? If so, you should take the paperwork and the vial together to document, make sure you double check the date (and immunization dates are important, as sometimes they are what are needed by a certain date to be able to attend school, take a trip, that type of thing). Make sure the date adds up with the date on the visit note. And always be sure you are giving the correct immunization to the correct patient. (or if you don't give immunizations, be sure that whomever does gives you what you need to scribe correctly.) And sometimes, if you are scribing intently, you can type in the wrong month, they may say the wrong month... especially when it is busy.

The bottom line is, your error is the MD's error--or the primary RN or LPN's error, as they are the people holding the licenses. So they do sometimes come down hard on unlicensed assistive personal, as they have to take "blame" for mistakes you may make. With that being said, in a busy office with lots of things going on, people make mistakes. Document as you go, do not leave it for the end of the day, and always double and triple check. Yes, it may slow you down, but that's ok--it is most important to be correct. Especially with time sensitive/time dependent immunization schedules.

It's unlikely that a nurse would be held liable for a mistake an MA makes. The physician who hires the MA is the one who would take the hit if there would be an adverse outcome from an error.

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